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Organization
DOMINICAN HOSPITAL FOUNDATION
Active
Organization
DOMINICAN HOSPITAL FOUNDATION
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
1667 DOMINICAN WAY, 134, SANTA CRUZ, CA 95065-1518
(831) 475-8834
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G35500
CA
Other
Enumeration date
05/06/2008
Last updated
10/22/2012
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